About one in eight people suffer from breathing difficulties caused by physical obstruction inside of the nose. This can be due to a deviated septum, enlarged turbinates or collapsed valves. Many times, internal breathing difficulties may occur or cause a nose that is twisted or pinched on the outside. When this occurs, A septorhinoplasty is a procedure which corrects the breathing as well as improving the outside appearance of the nose. A septorhinoplasty can improve nasal obstruction and help treat conditions including snoring, sleep apnea, snoring and sinus infections. Diagnosis of a nasal obstruction can be made by your ENT or allergist.
Medications may be successful in treating some causes of nasal obstruction like allergies, respiratory infections and nasal polyps and may also be useful to improve mild cases of nasal valve collapse, inferior turbinate hypertrophy and septal deviation. However, some cases of nasal obstruction are structural and require changing the structure of the nose to help. The deviated septum, shown below, blocks the nose and causes the outside of the nose to be twisted and collapsed. In these cases, surgery may be required which will both correct breathing deficiencies and give a more aesthetically pleasing shape to the nose. This is termed a septorhinoplasty. A rhinoplasty is different in that the goal is only improving the external appearance of the nose.
Real patient sinus CT scan of a Deviated Nasal Septum
Reasons to have a Septorhinoplasty
The combination of nasal airway obstruction and a nose that you want to change the shape of may require septorhinoplasty. A broken nose that is displaced can easily change the external nose. A deviated septum can cause the nasal dorsum and tip to be twisted. The nose may be pinched from external valve collapse and building the external valves will change the appearance and breathing function of the nose. Internal valve collapse either from trauma, previous surgery, or congenitally can cause an inverted-V defect on the outside of the nose and require correction.
Septorhinoplasty and a Broken Nose
Nasal fractures can break the nasal bones and fracture the bony or cartilaginous nasal septum. This can cause the nose to be twisted and may also block the breathing passageways. Symptoms of a deviated septum almost always include nasal obstruction. This nasal congestion is typically chronic and generally manifests itself more on one side than the other. Another symptom is irritation of the nose at the front of the septum on the deviated side. This can lead to frequent nosebleeds, crusting on that side, and facial pain in that area of the nose. Other common symptoms of a deviated septum include headaches and postnasal drip. A deviated septum can also predispose you to episodes of acute or chronic sinusitis.
Another sign that can be brought on or worsened by a deviated septum is loud breathing and snoring during sleep. This is usually something a bed partner will let you know about. Nasal obstruction can also cause or contribute to obstructive sleep apnea. If you feel tired during the day, have morning headaches, are told that you snore loudly or stop breathing while you are sleeping, you have symptoms of sleep apnea and want to get it checked out. The type of sleep apnea caused by nasal obstruction is known as obstructive sleep apnea (OSA), but no matter the type, the patient is rarely aware that he has the condition, even after waking. The condition can exist for years or even decades without diagnosis. When left untreated, sleep apnea can cause heart and lung problems as well as a general decrease in your productivity and quality of life.
Preparation For A Deviated Septum
You will meet with the doctor where he usually spends an hour going over everything related to your surgery. He will evaluate and make sure that he can specifically tailor a custom care plan to your exact needs. During the consultation, the doctor will determine the exact nature of your complaints and the exact causes. He may prescribe medications that will assist in your complaints. Once a tailored plan is made, Dr. Mourad and his staff will take you through all the necessary information needed to make sure that your surgery happens without issue. We take care of the details so that you can have the most enjoyable experience.
Dr. Mourad views treating his patients to be nothing short of a privilege and an honor and enjoys taking the time to get to know his patients and fully understand their issues. Norelle Health’s office provides a boutique experience that takes you out of the mindset of being at the doctor’s office. It is a warm, comfortable environment, providing a bespoke experience.
Deviated Septum Surgery
To straighten the nasal septum, a corrective surgical procedure called a Septoplasty is performed. Septoplasty may be indicated when medication and other treatments have failed. The purpose of the procedure is to allow easier breathing, decreased snoring, or improved sinus function. The doctor works through the nostrils to straighten the twisted cartilage and bone. The surgery is normally performed as an outpatient procedure. Most of these surgeries will take approximately sixty minutes and general anesthesia is usually required. You will usually go home about an hour after surgery.
If there are cosmetic deformities of the nose, the surgery may be combined with rhinoplasty — a procedure then called a septorhinoplasty.
The deviated portion of the septum is removed leaving a straighter and better functioning nasal cavity. If a full septorhinoplasty is conducted, a week or two of swelling and bruising afterward is normal. If just the septoplasty was performed, there will be little or no swelling on the outside of the nose.
Turbinate surgery, or turbinoplasty, may also be necessary when medication and allergy avoidance do not improve breathing. The turbinate size is reduced by out fracturing or removing the front of the enlarged inferior turbinate bone and shrinking the mucosa. Breathing will usually get better over the first couple of weeks and can I continue to improve over the next year or more. Turbinoplasty and septoplasty can be combined with sinus surgery as well as with rhinoplasty (nasal reshaping surgery).
What Is The Recovery Like From A Septorhinoplasty?
The recovery is not fun at all although it is generally not very painful. Most patients do have obstruction of both sides of the nose that lasts for most of the week or even until you see your doctor. Dr. Mourad provides pain medication if you need it but most of the time Tylenol or no medication is used. You return to our office one week after your procedure and your nose is decongested with any crusts removed from inside of the nose. Most patients are breathing better within a couple of weeks as the swelling inside of the nose improves.
What Are The Possible Complications From A Septorhinoplasty?
Frequent complications of septorhinoplasty include:
- Nasal septum bending or shifting after surgery.
- Crusting inside the nose.
- Persistent congestion or obstruction.
Some very rare complications of septoplasty include:
- Nasal septum perforation.
- Septal hematoma and septal abscess.
- Adhesions and synachiae.
- Saddle nose.
- Dropped nasal tip.